StrokeNCT07066670
Strain Counterstrain and Muscle Energy Technique in Patients of Knee Osteoarthritis
A study testing Strain Counterstrain with Routine Physical Therapy and Muscle Energy Technique with Routine Physical Therapy in people with Stroke, run by University of Lahore at 1 site in Pakistan.
Trial summary
This study aimed to evaluate the comparative effects of Strain Counterstrain (SCS) and Muscle Energy Technique (MET) on pain, range of motion (ROM), and functional disability in patients with knee osteoarthritis (KOA). Read more about this study
- Who is it for?
- Ages 45 to 65 years
- Conditions the study is for
- Stroke
- What is being tested?
- Strain Counterstrain with Routine Physical Therapy and Muscle Energy Technique with Routine Physical Therapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 76 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Mar 2024to 20 Feb 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 45 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age between 45 to 65 years (Pandiselvi, 2019).
- Patients who were willing and able to comply with the study protocol and follow-up procedures (Arslan et al., 2022).
- Patients having Grade 2 knee OA Kellgren and Lawrence system. In this system, grade 2 signifies minimal severity of OA (Ratzlaff et al., 2018).
Who cannot join
- Congenital deformities (Deng et al., 2021).
- Having any tumor or related pathology such as cancer (Arslan et al., 2022).
- Patients having any previous knee surgery (Khan et al., 2023).
- Patients with isolated/predominantly patellofemoral symptomatic osteoarthritis, inflammatory diseases, joint effusion, or excessive knee deformity (Deng et al., 2021).
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparative Effects of Strain Counterstrain and Muscle Energy Technique on Pain, Range of Motion, and Functional Disability in Patients of Knee Osteoarthritis
This study aimed to evaluate the comparative effects of Strain Counterstrain (SCS) and Muscle Energy Technique (MET) on pain, range of motion (ROM), and functional disability in patients with knee osteoarthritis (KOA). Conducted as a single-blinded randomized control trial at the University of Lahore Teaching Hospital, 76 participants were divided into two groups, receiving either SCS or MET alongside routine physical therapy. Outcome measures included pain intensity, ROM, and functional disability via KOOS.
Read the detailed description
This randomized controlled trial investigated the comparative efficacy of Strain Counterstrain (SCS) and Muscle Energy Technique (MET) in managing knee osteoarthritis (KOA) symptoms. A total of 76 patients meeting inclusion criteria were randomly assigned into two equal groups. Group A received SCS along with routine physical therapy, and Group B received MET with the same physiotherapy protocol. The interventions were carried out five days a week for eight weeks, and outcomes were measured at baseline, four weeks, and eight weeks. Pain was assessed using the Numeric Rating Scale (NRS), range of motion (ROM) via goniometry, and functional disability using the KOOS index.
- Conditions
- Stroke
- Being tested
- Strain Counterstrain with Routine Physical Therapy, Muscle Energy Technique with Routine Physical Therapy
- Keywords
- Knee Osteoarthritis, Strain Counterstrain, Muscle Energy Technique, Pain Management, Functional Disability
- Medical subject headings
- Stroke, Osteoarthritis, Knee, Agnosia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Strain Counterstrain with Routine Physical TherapyBehavioural
This intervention involves applying the Strain Counterstrain (SCS) technique in combination with standard physical therapy. SCS targets tender points through passive positioning to reduce muscle tension and pain. The patient is positioned in a position of comfort for 90 seconds while monitoring the tender point. This is followed by gradual return to neutral. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), strengthening (short arc quads, terminal knee extension), and stretching exercises. The therapy is administered 5 days per week over 8 weeks.
Muscle Energy Technique with Routine Physical TherapyBehavioural
This intervention combines Muscle Energy Technique (MET) with routine physical therapy. MET involves voluntary muscle contractions against resistance, followed by stretching to restore range of motion and relieve pain. Techniques include post-isometric relaxation and slow eccentric isotonic stretching, particularly targeting hamstring and quadriceps tightness. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), as well as structured strengthening and stretching exercises. The intervention was delivered 5 days a week for 8 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Strain Counterstrain with Routine Physical Therapy | Experimental | Participants in this arm received Strain Counterstrain (SCS) along with routine physical therapy. SCS involved identifying and holding tender points in positions of comfort for 90 seconds to relieve pain and improve range of motion. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was delivered 5 days a week for 8 weeks. Education on weight management and joint protection strategies was also provided. Receives: Behavioral: Strain Counterstrain with Routine Physical Therapy |
| Muscle Energy Technique with Routine Physical Therapy | Experimental | Participants in this arm received Muscle Energy Technique (MET) along with routine physical therapy. MET involved post-isometric relaxation and slow eccentric isotonic stretching techniques targeting hamstrings and quadriceps, helping to restore joint mobility and muscle flexibility. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was administered 5 days per week over 8 weeks, along with patient education on lifestyle and joint care. Receives: Behavioral: Muscle Energy Technique with Routine Physical Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity reduction measured by Numeric Pain Rating Scale (NPRS)
Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), a validated 0-10 scale where 0 indicates "no pain" and 10 indicates "worst possible pain." Assessments were conducted at baseline, 4 weeks, and 8 weeks. A lower score represents improvement.
Measured: Baseline, Week 4, and Week 8
Secondary outcomes (2)
Improvement in range of motion (ROM) measured using goniometry
Range of motion (ROM) of the affected knee was measured using a standard universal goniometer. The focus was on knee flexion and extension. Measurements were taken at baseline, 4 weeks, and 8 weeks to evaluate changes over time.
Measured: Baseline, Week 4, and Week 8
Change in functional disability measured by KOOS questionnaire
Functional disability was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). It includes five subscales (pain, symptoms, ADL, sport/recreation, QOL). Higher scores indicate better function. Assessed at baseline, 4 weeks, and 8 weeks.
Measured: Baseline, Week 4, and Week 8
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Jul 2025
- Study start15 Mar 2024
- Primary completion13 Dec 2024
- Study completion20 Feb 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for StrokeStudies of the same condition, open and under way.
- More trials run by University of LahoreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Two-arm parallel design where each group receives a distinct manual therapy intervention (SCS or MET) along with standardized physiotherapy. The study tracks changes in pain, ROM, and disability over 8 weeks.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 76 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Lahore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Iqra zahid, University of Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07066670
- Sponsor's protocol ID
- Rec-UOL-/204/08/24
- Status last verified
- Apr 2025
- First submitted
- 3 Apr 2025
- Last updated
- 15 Jul 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Ratzlaff C, Ashbeck EL, Guermazi A, Roemer FW, Duryea J, Kwoh CK. A quantitative metric for knee osteoarthritis: reference values of joint space loss. Osteoarthritis Cartilage. 2018 Sep;26(9):1215-1224. doi: 10.1016/j.joca.2018.05.014. Epub 2018 May 26.
PubMed 29842940
Study at a glance
From the registry record, last updated by the sponsor on 15 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Strain Counterstrain and Muscle Energy Technique on Pain, Range of Motion, and Functional Disability in Patients of Knee Osteoarthritis
- ClinicalTrials.gov ID
- NCT07066670
- Acronym / sponsor ID
- Rec-UOL-/204/08/24
- Conditions
- Stroke
- Keywords
- Knee Osteoarthritis, Strain Counterstrain, Muscle Energy Technique, Pain Management, Functional Disability
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 76 participants (actual)
- Lead sponsor
- University of LahoreUniversity, hospital or other
- Study start
- 15 Mar 2024 (actual)
- Primary completion
- 13 Dec 2024 (actual)
- Study completion
- 20 Feb 2025 (actual)
- First posted
- 15 Jul 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aimed to evaluate the comparative effects of Strain Counterstrain (SCS) and Muscle Energy Technique (MET) on pain, range of motion (ROM), and functional disability in patients with knee osteoarthritis (KOA). Conducted as a single-blinded randomized control trial at the University of Lahore Teaching Hospital, 76 participants were divided into two groups, receiving either SCS or MET alongside routine physical therapy. Outcome measures included pain intensity, ROM, and functional disability via KOOS.
Detailed description
This randomized controlled trial investigated the comparative efficacy of Strain Counterstrain (SCS) and Muscle Energy Technique (MET) in managing knee osteoarthritis (KOA) symptoms. A total of 76 patients meeting inclusion criteria were randomly assigned into two equal groups. Group A received SCS along with routine physical therapy, and Group B received MET with the same physiotherapy protocol. The interventions were carried out five days a week for eight weeks, and outcomes were measured at baseline, four weeks, and eight weeks. Pain was assessed using the Numeric Rating Scale (NRS), range of motion (ROM) via goniometry, and functional disability using the KOOS index.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Two-arm parallel design where each group receives a distinct manual therapy intervention (SCS or MET) along with standardized physiotherapy. The study tracks changes in pain, ROM, and disability over 8 weeks.
| Arm | Type | Receives |
|---|---|---|
| Strain Counterstrain with Routine Physical Therapy | Experimental | Behavioral: Strain Counterstrain with Routine Physical TherapyParticipants in this arm received Strain Counterstrain (SCS) along with routine physical therapy. SCS involved identifying and holding tender points in positions of comfort for 90 seconds to relieve pain and improve range of motion. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was delivered 5 days a week for 8 weeks. Education on weight management and joint protection strategies was also provided. |
| Muscle Energy Technique with Routine Physical Therapy | Experimental | Behavioral: Muscle Energy Technique with Routine Physical TherapyParticipants in this arm received Muscle Energy Technique (MET) along with routine physical therapy. MET involved post-isometric relaxation and slow eccentric isotonic stretching techniques targeting hamstrings and quadriceps, helping to restore joint mobility and muscle flexibility. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was administered 5 days per week over 8 weeks, along with patient education on lifestyle and joint care. |
Who may qualify
- Ages
- 45 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Age between 45 to 65 years (Pandiselvi, 2019).
- Patients who were willing and able to comply with the study protocol and follow-up procedures (Arslan et al., 2022).
- Patients having Grade 2 knee OA Kellgren and Lawrence system. In this system, grade 2 signifies minimal severity of OA (Ratzlaff et al., 2018).
Key exclusion criteria (4 listed)
- Congenital deformities (Deng et al., 2021).
- Having any tumor or related pathology such as cancer (Arslan et al., 2022).
- Patients having any previous knee surgery (Khan et al., 2023).
- Patients with isolated/predominantly patellofemoral symptomatic osteoarthritis, inflammatory diseases, joint effusion, or excessive knee deformity (Deng et al., 2021).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Strain Counterstrain with Routine Physical TherapyThis intervention involves applying the Strain Counterstrain (SCS) technique in combination with standard physical therapy. SCS targets tender points through passive positioning to reduce muscle tension and pain. The patient is positioned in a position of comfort for 90 seconds while monitoring the tender point. This is followed by gradual return to neutral. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), strengthening (short arc quads, terminal knee extension), and stretching exercises. The therapy is administered 5 days per week over 8 weeks. | Behavioural | Strain Counterstrain with Routine Physical Therapy |
| Muscle Energy Technique with Routine Physical TherapyThis intervention combines Muscle Energy Technique (MET) with routine physical therapy. MET involves voluntary muscle contractions against resistance, followed by stretching to restore range of motion and relieve pain. Techniques include post-isometric relaxation and slow eccentric isotonic stretching, particularly targeting hamstring and quadriceps tightness. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), as well as structured strengthening and stretching exercises. The intervention was delivered 5 days a week for 8 weeks. | Behavioural | Muscle Energy Technique with Routine Physical Therapy |
Primary outcome
Pain intensity reduction measured by Numeric Pain Rating Scale (NPRS)
Time frame: Baseline, Week 4, and Week 8
Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), a validated 0-10 scale where 0 indicates "no pain" and 10 indicates "worst possible pain." Assessments were conducted at baseline, 4 weeks, and 8 weeks. A lower score represents improvement.
2 secondary outcomes
Improvement in range of motion (ROM) measured using goniometry
Time frame: Baseline, Week 4, and Week 8
Change in functional disability measured by KOOS questionnaire
Time frame: Baseline, Week 4, and Week 8
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jul 2025.
- Background: PubMed 29842940Ratzlaff C, Ashbeck EL, Guermazi A, Roemer FW, Duryea J, Kwoh CK. A quantitative metric for knee osteoarthritis: reference values of joint space loss. Osteoarthritis Cartilage. 2018 Sep;26(9):1215-1224. doi: 10.1016/j.joca.2018.05.014. Epub 2018 May 26.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Strain Counterstrain with Routine Physical Therapy and Muscle Energy Technique with Routine Physical Therapy in people with Stroke, run by University of Lahore at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain intensity reduction measured by Numeric Pain Rating Scale (NPRS) (time frame: Baseline, Week 4, and Week 8). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07066670, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2025.